SGLT2i联合ARB对合并2型糖尿病的老年单纯收缩期高血压患者血压的影响分析

Effect of SGLT2i combined with ARB on blood pressure in elderly patients with isolated systolic hypertension complicated with type 2 Diabetes Mellitus

目的探讨钠-葡萄糖协同转运蛋白2抑制剂(sodium-dependent glucose transporter 2 inhibitor,SGLT2i)联合血管紧张素Ⅱ受体拮抗剂(angiotensinⅡreceptor blocker,ARB)对合并2型糖尿病的老年单纯收缩期高血压患者血压的影响。方法选取2019年9月至2022年9月于承德市中心医院心血管内科门诊就诊的合并2型糖尿病的老年单纯收缩期高血压患者150例为研究对象,根据随机数表法分为对照组(n=75)及实验组(n=75)。实验组采用厄贝沙坦150 mg/d联合达格列净10 mg/d口服治疗,对照组采用厄贝沙坦150 mg/d联合氢氯噻嗪12.5 mg/d口服治疗,对比两组治疗前后收缩压、脉压、平均动脉压、尿酸水平变化,分析两组肥胖改善率及治疗期间发生低钾血症和泌尿系感染的不良反应情况。结果治疗后,两组收缩压、脉压、平均动脉压均较治疗前降低且差异有统计学意义(P<0.05);在治疗12周后,实验组收缩压、脉压水平分别为(147.51±6.22)mmHg、(80.63±6.06)mmHg均低于对照组的(150.47±6.77)mmHg、(83.27±6.06)mmHg,差异具有统计学意义(P=0.006、P=0.008)。实验组肥胖改善率优于对照组(1 mmHg=0.133kPa),差异有统计学意义(P=0.034)。治疗期间实验组发生低钾血症概率低于对照组,差异有统计学意义(P=0.042)。结论SGLT2i联合ARB可有效降低合并2型糖尿病的老年单纯收缩期高血压患者的收缩压及脉压,且临床安全性可靠。

Objective To investigate the effect of sodium-dependent glucose transporter 2 inhibitor(SGLT2i)combined with angiotensinⅡreceptor blocker(ARB)on blood pressure in elderly patients with isolated systolic hypertension with type 2 diabetes mellitus.Methods A total of 150 elderly patients with isolated systolic hypertension with type 2 diabetes mellitus who attended the outpatient clinic of the Department of Cardiology of Chengde Central Hospital from September 2019 to September 2022 were collected.The experimental group was treated orally with irbesartan 150 mg/d and daglizin 10 mg/day,while the control group was treated orally with irbesartan 150 mg/d combined with hydrochlorothiazide 12.5 mg/d.The changes in systolic blood pressure,pulse pressure,mean arterial pressure,and uric acid levels before and after treatment were compared with baseline,and the improvement rate of obesity and the adverse reactions of hypokalemia and urinary tract infection during treatment were compared.Results After the two groups of treatment,systolic blood pressure,pulse pressure,and mean arterial pressure were all lower than before treatment,and after 12 weeks of treatment,the systolic blood pressure and pulse pressure levels in the experimental group were 147.51±6.22 mmHg and 80.63±6.06 mmHg lower than those in the control group 150.47±6.77 mmHg and 83.27±6.06 mmHg,respectively,and the differences were statistically significant(P=0.006,P=0.008).The improvement rate of obesity in the experimental group was better than that in the control group,and the difference was statistically significant(P=0.034).The probability of hypokalemia during treatment was lower than that of the control group,and the difference was statistically significant(P=0.042).Conclusion SGLT2i combined with ARB can effectively reduce systolic blood pressure and pulse pressure in elderly patients with isolated systolic hypertension complicated with type 2 diabetes mellitus,and it is safe and reliable in clinics.